Provider Demographics
NPI:1932675493
Name:WOOD, REBECCA
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30941 MILL LN
Mailing Address - Street 2:STE B
Mailing Address - City:SPANISH FORT
Mailing Address - State:AL
Mailing Address - Zip Code:36527-5457
Mailing Address - Country:US
Mailing Address - Phone:251-626-8242
Mailing Address - Fax:
Practice Address - Street 1:30941 MILL LN STE B
Practice Address - Street 2:
Practice Address - City:SPANISH FORT
Practice Address - State:AL
Practice Address - Zip Code:36527-5457
Practice Address - Country:US
Practice Address - Phone:251-626-8242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-22
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2587111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor